20D0649607 CLIA NUMBER - NORTHLAND LIVING CENTER

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Field Name	Field Value
CLIA Number	20D0649607
LAB Type	Intermediate Care Facility for Mentally Retarded
Facility Name	NORTHLAND LIVING CENTER
Street	382 MAIN STREET
City	JACKMAN
State	ME
ZIP	04945
Phone	207 668-3221
Certificate Type	Certificate of Waiver
Certificate Type Description	This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date	9/1/2024
Certificate Expiration Date	8/31/2026
Facility Type	Intermediate Care Facility for Mentally Retarded
Lab Director	REBECCA BEGIN RN

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This page was last updated on: 9/29/2025